A Rare Case of Intestinal Malrotation and Volvulus of Jejunum with Coexisting Carcinoid Tumour of Appendix
Published: June 1, 2017 | DOI: https://doi.org/10.7860/JCDR/2017/25575.10040
Priyanka Tiwari, Darshan Patel, Vimal Dhaduk, Prasanna Kumar Reddy, Jainudeen Khalander Abdul Jameel
1. Registrar, Department of Gastrosurgery and Minimal Access Surgery, Apollo Mains Hospital, Tamil Nadu, India.
2. Registrar, Department of Gastrosurgery and Minimal Access Surgery, Apollo Mains Hospital, India.
3. Registrar, Department of Gastrosurgery and Minimal Access Surgery, Apollo Mains Hospital, India.
4. Senior Consultant and Head, Department of Gastrosurgery and Minimal Access Surgery, Apollo Mains Hospital, Tamil Nadu, India.
5. Senior Consultant, Department of Gastrosurgery and Minimal Access Surgery, Apollo Mains Hospital, Tamil Nadu, India.
Correspondence
Dr. Priyanka Tiwari,
72, Gengu Reddy Road, Egmore, Chennai Apollo Girls Hostel, Room No 2A, Chennai-600006, Tamil Nadu, India.
E-mail: dr.priyankatiwari@hotmail.com
Malrotation of the midgut is generally regarded as a paediatric pathology. It is rare in adults. Patients may present with symptoms of acute bowel obstruction or chronic abdominal pain. Barium study, Contrast Enhanced Computed Tomography (CECT), Magnetic Resonance Imaging (MRI), diagnostic laparoscopy and sometimes explorative laparotomy are used for diagnosis. Ladd’s procedure through the open approach has been the treatment of choice for complete malrotation of midgut, however there are reports on successful outcome for both complete and incomplete malrotation after laparoscopic approach as well. We report a case of a 25-year-old female who presented with a history of severe pain in abdomen for one week. CECT abdomen showed incomplete malrotation and volvulus in midgut. Laparoscopic detorsion of bowel loops, adhesiolysis, caecopexy and appendectomy was done. Patient’s symptoms subsided immediately after surgery. Histological analysis of the appendix specimen showed small appendiceal carcinoid, which was purely incidental. At three months follow up, patient was symptom free.
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